RN COMPREHENSIVE ONLINE
PRACTICE 2023 B QUESTIONS WITH
CORRECT AMSWERS
Awlnursewliswlcaringwlforwlawl5-year-oldwlchild
PhysicalwlExamination:
1510:
Uponwlvisualwlinspection,wlthroatwliswlinflamed,wltonsilswlappearwlpink,wlreddenedwlandwle
piglottiswliswledematouswlandwlcherrywlredwlinwlappearance.wlSkinwlappearswlpale.wlStridor
wlnotedwluponwlinspirationwlwithwldiminishedwlbilateralwllungwlsounds.
Nurse'swlNotes:
1500
Childwlaccompaniedwltowlemergencywldepartmentwlbywlcaregiver.wlCaregiverwlstateswlchil
dwlhaswlawlsorewlthroatwlandwlreportswlthewlchildwlhaswl"painwlonwlswallowing"wlandwldenie
swlcough.wlChildwliswlagitatedwlandwlleanwl-wlANS--Condition:wlEpiglottis
Actions:wlInitiatewldropletwlprecautionswlandwlrequestwlawlprescriptionwlforwlIVwlantibiotics
Monitors:wlBreathwlsoundswlandwltemperature
Thewlnursewlshouldwlanticipatewlinitiatingwldropletwlprecautionswlandwlrequestingwlawlpresc
riptionwlforwlIVwlantibiotics.wlThewlchildwliswlmostwllikelywlexperiencingwlepiglottiswlbecause
wlofwlthewlclinicalwlmanifestationswlofwlawlhighwlfever,wlinflammationwlandwlrednesswlofwlthe
wlthroat,wlpalewlskin,wlstridorwlwithwlinspiration,wlpainfulwlswallowing,wlnowlcough,wliswlsittin
gwlinwltripodwlposition,wlandwldrooling.wlThewlnursewlshouldwlmonitorwlthewlchild'swltempera
turewlandwlbreathwlsounds.
Awlnursewliswlcaringwlforwlawlclientwlwhowliswlonwlthewlspinalwlcordwlinjurywl(SCI)wlunit
Nurses'wlNotes
Daywl3,wl1700
ClientwladmittedwltowlSCIwlunitwl3wldayswlagowlfollowingwlC7wlinjury.wlSkinwliswlcool,wlpale,w
landwldrywltowltouch.wlRespirationswleasywlandwlunlabored.wlLungwlsoundswldiminishedwlin
wllowerwllobes.wlAbdomenwlsoftwlandwlnondistendedwlwithwlactivewlbowelwlsounds.wlClient
wlpassedwlawlsmallwlamountwlofwlhardwlformedwlstoolwlthiswlAM.wlIndwellingwlurinarywlcathe
terwldrainingwlclearwlyellowwlurine.wlDeepwltendonwlreflexeswl(DTR)wlarewlbicepswl1+,wltric
epswl1+,wlpawl-wlANS--
Thewlclientwliswlmostwllikelywlexperiencingwlmanifestationswlofwlpneumoniawlandwlautonom
icwldysreflexia.
,Thewlnursewlshouldwlanalyzewlcueswlfromwlthewlclient'swlmanifestationswlandwldeterminewlt
hatwlthewlclientwliswlmostwllikelywlexperiencingwlmanifestationswlofwlpneumoniawlandwlauto
nomicwldysreflexia.wlAwlclientwlwhowlhaswlawlcervicalwlSCIwliswlatwlriskwlforwlrespiratorywlco
mplicationswlbecausewlspinalwlinnervationwltowlthewlrespiratorywlmuscleswliswldisrupted.wlA
dventitiouswlbreathwlsoundswlinwlthewllowerwllobeswlbilaterallywlandwlawldecreasewlinwloxyg
enwlsaturationwltowllesswlthanwl92%wlcanwlindicatewlpneumonia.wlThewlclient'swlsuddenwlin
creasewlinwlbloodwlpressure,wlbradycardia,wlflushingwlofwlthewlskinwlabovewlthewlareawlofwlt
hewlinjury,wlheadache,wlandwlblurredwlvisionwlarewlmanifestationswlofwlautonomicwldysrefle
xia,wlwhichwlcanwlbewlawllife-threateningwlcondition.
Awlnursewliswlcaringwlforwlawlclientwlwhowlhaswlabdominalwlpain
Nurses'wlNotes
0900
Clientwlreportswllosswlofwlappetite,wlweightwlloss,wlandwlfatiguewlforwl1wlweek.wlReportswlab
dominalwlpain,wl6wlonwlawlscalewlfromwl0wltowl10,wlforwl2wldays.wlClientwliswlawlperioperative
wlnurse,wlreturnedwl1wlweekwlagowlfromwlawl2-
weekwlmissionwltripwltowlanwlunderdevelopedwlcountry
1200
Resultswlofwlantibodywlstudieswlobtained.wlProviderwlprescriptionwlforwlantiviralwlmedicatio
nwlpending.
PhysicalwlExamination
0930
Lungwlsoundswlclearwlbilaterally.wlSkinwlwarmwltowltouchwlandwljauwl-wlANS--
HepatitiswlA:wlClient'swlriskwlfromwlfecal-
oralwltransmission,wllaboratorywlresults,wlandwlphysicalwlexaminationwlfindings
HepatitiswlB:wlAntiviralwltreatment,wllaboratorywlresults,wlclient'swlriskwlfromwlbloodbornewlt
ransmission,wlphysicalwlexaminationwlfindings
HepatitiswlC:wlAntiviralwltreatment,wllaboratorywlresults,wlclient'swlriskwlfromwlbloodbornewlt
ransmission,wlandwlphysicalwlexaminationwlfindings
Whenwlanalyzingwlcues,wlthewlnursewlshouldwlrecognizewlthatwlmanifestationswlofwlhepatiti
swlA,wlhepatitiswlB,wlandwlhepatitiswlCwlincludewljaundice,wlyellowwlsclerae,wlrightwlupperwlq
uandrantwlpainwluponwlpalpation,wldarkwlyellowwlurine,wlandwlelevatedwlASTwlandwlALTwlle
vels.wlWhenwlanalyzingwlcues,wlthewlnursewlshouldwlalsowlrecognizewlthewlclient'swlriskwlfor
wlcontractingwlhepatitiswlAwlthroughwlthewlfecal-
oralwlroutewlduringwlrecentwltravelwltowlanwlunderdevelopedwlcountrywlandwlthewlclient'swlo
ccupationalwlriskwlaswlawlperioperativewlnursewlforwlcontractingwlhepatitiswlBwlandwlhepatiti
swlCwlthroughwlbloodbornewltransmission.wlThewlnursewlshouldwlrecognizewlthatwlthewlcurr
entwlstandardwlofwlpracticewlfor
Awlnursewliswlcaringwlforwlawlclientwlonwlawlmedical-surgicalwlunit
,VitalwlSigns
0700
Temperaturewl37.6wlCwl(99.7wlF)
Heartwlratewl100/min
Respiratorywlratewl22/min
Bloodwlpressurewl115/70wlmmHg
Oxygenwlsaturationwl98%wlonwlroomwlair
Nurses'wlNotes
1100
Clientwlalertwlandwlorientedwltowlperson,wlplace,wlandwltime.wlClientwlhadwlepisodewlofwldiar
rhea,wlprovidedwlperinealwlcare.wlNotedwl2wlcmwlxwl2wlcmwl(0.8wlinwlxwl0.8wlin)wlpainfulwled
ematouswlareawlonwlsacrum.wlClientwlrepositionedwleverywl4wlhr.wl-wlANS--
Clickwltowlhighlightwlthewlfindingswlthatwlrequirewlfollowwlup.wlTowldeselectwlawlfinding,wlclic
kwlonwlthewlfindingwlagain.
-wlNotedwl2wlcmwlxwl2wlcmwl(0.8wlinwlxwl0.8wlin)wlpainfulwledematouswlareawlonwlsacrum
-wlClientwlrepositionedwleverywl4wlhr
Whenwlrecognizingwlcues,wlthewlnursewlshouldwldeterminewlthatwlthewlclient'swlpainfulwled
ematouswlareawlonwltheirwlsacrumwlandwlthatwlthewlclientwlhaswlonlywlbeenwlrepositionedwl
everywl4wlhrwlrequireswlfollowwlup.wlThewlclientwlhaswlmanifestationswlofwlawlpressurewlinjur
ywlthatwlneedwltowlbewladdressed.wlThewlclientwlshouldwlbewlrepositionedwlatwlleastwleveryw
l2wlhrwltowlpreventwlworseningwlofwlthewlpressurewlinjurywlandwltowlrelievewlpressurewlfromwl
thewlsacralwlarea.
Awlnursewlinwlanwloutpatientwlmentalwlhealthwlclinicwliswlcaringwlforwlawlclient
VitalwlSigns
3wlmonthswlago
Bloodwlpressurewl116/68wlmmHg
Heartwlratewl82/min
Respiratorywlratewl16/min
Temperaturewl36.7wlCwl(98.1wlF)
SaO2wl97%wlonwlroomwlair
Today:
Bloodwlpressurewl128/76wlmmHg
Heartwlratewl104/min
Respiratorywlratewl22/min
Temperaturewl37.4wl(99.4wlF)
SaO2wl97%wlonwlroomwlair
Nurses'wlNotes
3wlmonthswlago
, Clientwlrecentlywladmittedwlwithwlnewwldiagnosiswlofwlschizophrenia.wlReceivedwlinpatient
wltreatmentwlforwl10wldayswlandwlwaswldischargedwl1wlweekwlago.wl-wlANS--
Selectwlthewl3wlfindingswlthatwlrequirewlimmediatewlfollowwlup:
-wlAuditorywlhallucinations
-wlSpeech
-wlRestlessness
Whenwlrecognizingwlcues,wlthewlnursewlshouldwlidentifywlthatwlthewlfindingswlofwlrestlessne
ss,wlauditorywlhallucinations,wlandwlpressuredwlspeechwlrequirewlimmediatewlfollowwlup.wl
Thesewlfindingswlarewlindicationswlofwlpsychosis.wlThewlnursewlshouldwlnotifywlthewlprovid
erwlforwladditionalwlevaluationwlandwltreatment.
Awlnursewliswlcaringwlforwlawlclientwlwhowliswlpostoperativewlfollowingwlcoronarywlarterywlby
passwlsurgerywl(CABG)
LaboratorywlResults
0630
Sodiumwl145wlmEq/Lwl(136wltowl145wlmEq/L)
Potassiumwl3.2wlmEq/Lwl(3.5wltowl5wlmEq/L)
Chloridewl116wlmEq/Lwl(98wltowl106wlmEq/L)
BUNwl24wlmg/dLwl(10wltowl20wlmg/dL)
Magnesiumwl1.5wlmEq/Lwl(1.3wltowl2.1wlmEq/L)
Totalwlcalciumwl9wlmg/dLwl(9wltowl10.5wlmg/dL)
Phosphatewl4.6wlmg/dLwl(3wltowl4.5wlmg/dL)
Glucosewl95wlmg/dLwl(74wltowl106wlmg/dL)
WBCwlcountwl9,500/mm3wl(5,000wltowl10,000/mm3)
Iwl&wlO
0700
4wlhrwlinputwl400wlmL
4wlhrwloutputwl-wlANS--
Thewlclientwliswlatwlgreatestwlriskwlforwldevelopingwldysrhythmias,wlaswlevidencedwlbywlele
ctrolytewlimbalance.
Thewlnursewlshouldwlanalyzewlcueswltowldeterminewlthewlclientwliswlatwlgreatestwlriskwlforwld
evelopingwldysrhythmiaswlrelatedwltowlhypokalemia,wlaswlevidencedwlbywlthewllaboratorywl
reportwlandwlthewlclient'swlreportwlofwlmusclewlcramping.wlPotassiumwlandwlmagnesiumwld
epletionwlarewlcommonwlmanifestationswlinwlclientswlwhowlarewlpostoperativewlfollowingwl
CABG.wlDuewltowlmedicationwlorwlhemodilation,wlitwliswlimportantwlforwlthewlnursewltowlclos
elywlmonitorwlelectrolytes.
Awlnursewliswlcaringwlforwlawlclientwlwhowliswlpregnantwlinwlthewlacutewlcarewlsetting
Nurses'wlNotes
1400
PRACTICE 2023 B QUESTIONS WITH
CORRECT AMSWERS
Awlnursewliswlcaringwlforwlawl5-year-oldwlchild
PhysicalwlExamination:
1510:
Uponwlvisualwlinspection,wlthroatwliswlinflamed,wltonsilswlappearwlpink,wlreddenedwlandwle
piglottiswliswledematouswlandwlcherrywlredwlinwlappearance.wlSkinwlappearswlpale.wlStridor
wlnotedwluponwlinspirationwlwithwldiminishedwlbilateralwllungwlsounds.
Nurse'swlNotes:
1500
Childwlaccompaniedwltowlemergencywldepartmentwlbywlcaregiver.wlCaregiverwlstateswlchil
dwlhaswlawlsorewlthroatwlandwlreportswlthewlchildwlhaswl"painwlonwlswallowing"wlandwldenie
swlcough.wlChildwliswlagitatedwlandwlleanwl-wlANS--Condition:wlEpiglottis
Actions:wlInitiatewldropletwlprecautionswlandwlrequestwlawlprescriptionwlforwlIVwlantibiotics
Monitors:wlBreathwlsoundswlandwltemperature
Thewlnursewlshouldwlanticipatewlinitiatingwldropletwlprecautionswlandwlrequestingwlawlpresc
riptionwlforwlIVwlantibiotics.wlThewlchildwliswlmostwllikelywlexperiencingwlepiglottiswlbecause
wlofwlthewlclinicalwlmanifestationswlofwlawlhighwlfever,wlinflammationwlandwlrednesswlofwlthe
wlthroat,wlpalewlskin,wlstridorwlwithwlinspiration,wlpainfulwlswallowing,wlnowlcough,wliswlsittin
gwlinwltripodwlposition,wlandwldrooling.wlThewlnursewlshouldwlmonitorwlthewlchild'swltempera
turewlandwlbreathwlsounds.
Awlnursewliswlcaringwlforwlawlclientwlwhowliswlonwlthewlspinalwlcordwlinjurywl(SCI)wlunit
Nurses'wlNotes
Daywl3,wl1700
ClientwladmittedwltowlSCIwlunitwl3wldayswlagowlfollowingwlC7wlinjury.wlSkinwliswlcool,wlpale,w
landwldrywltowltouch.wlRespirationswleasywlandwlunlabored.wlLungwlsoundswldiminishedwlin
wllowerwllobes.wlAbdomenwlsoftwlandwlnondistendedwlwithwlactivewlbowelwlsounds.wlClient
wlpassedwlawlsmallwlamountwlofwlhardwlformedwlstoolwlthiswlAM.wlIndwellingwlurinarywlcathe
terwldrainingwlclearwlyellowwlurine.wlDeepwltendonwlreflexeswl(DTR)wlarewlbicepswl1+,wltric
epswl1+,wlpawl-wlANS--
Thewlclientwliswlmostwllikelywlexperiencingwlmanifestationswlofwlpneumoniawlandwlautonom
icwldysreflexia.
,Thewlnursewlshouldwlanalyzewlcueswlfromwlthewlclient'swlmanifestationswlandwldeterminewlt
hatwlthewlclientwliswlmostwllikelywlexperiencingwlmanifestationswlofwlpneumoniawlandwlauto
nomicwldysreflexia.wlAwlclientwlwhowlhaswlawlcervicalwlSCIwliswlatwlriskwlforwlrespiratorywlco
mplicationswlbecausewlspinalwlinnervationwltowlthewlrespiratorywlmuscleswliswldisrupted.wlA
dventitiouswlbreathwlsoundswlinwlthewllowerwllobeswlbilaterallywlandwlawldecreasewlinwloxyg
enwlsaturationwltowllesswlthanwl92%wlcanwlindicatewlpneumonia.wlThewlclient'swlsuddenwlin
creasewlinwlbloodwlpressure,wlbradycardia,wlflushingwlofwlthewlskinwlabovewlthewlareawlofwlt
hewlinjury,wlheadache,wlandwlblurredwlvisionwlarewlmanifestationswlofwlautonomicwldysrefle
xia,wlwhichwlcanwlbewlawllife-threateningwlcondition.
Awlnursewliswlcaringwlforwlawlclientwlwhowlhaswlabdominalwlpain
Nurses'wlNotes
0900
Clientwlreportswllosswlofwlappetite,wlweightwlloss,wlandwlfatiguewlforwl1wlweek.wlReportswlab
dominalwlpain,wl6wlonwlawlscalewlfromwl0wltowl10,wlforwl2wldays.wlClientwliswlawlperioperative
wlnurse,wlreturnedwl1wlweekwlagowlfromwlawl2-
weekwlmissionwltripwltowlanwlunderdevelopedwlcountry
1200
Resultswlofwlantibodywlstudieswlobtained.wlProviderwlprescriptionwlforwlantiviralwlmedicatio
nwlpending.
PhysicalwlExamination
0930
Lungwlsoundswlclearwlbilaterally.wlSkinwlwarmwltowltouchwlandwljauwl-wlANS--
HepatitiswlA:wlClient'swlriskwlfromwlfecal-
oralwltransmission,wllaboratorywlresults,wlandwlphysicalwlexaminationwlfindings
HepatitiswlB:wlAntiviralwltreatment,wllaboratorywlresults,wlclient'swlriskwlfromwlbloodbornewlt
ransmission,wlphysicalwlexaminationwlfindings
HepatitiswlC:wlAntiviralwltreatment,wllaboratorywlresults,wlclient'swlriskwlfromwlbloodbornewlt
ransmission,wlandwlphysicalwlexaminationwlfindings
Whenwlanalyzingwlcues,wlthewlnursewlshouldwlrecognizewlthatwlmanifestationswlofwlhepatiti
swlA,wlhepatitiswlB,wlandwlhepatitiswlCwlincludewljaundice,wlyellowwlsclerae,wlrightwlupperwlq
uandrantwlpainwluponwlpalpation,wldarkwlyellowwlurine,wlandwlelevatedwlASTwlandwlALTwlle
vels.wlWhenwlanalyzingwlcues,wlthewlnursewlshouldwlalsowlrecognizewlthewlclient'swlriskwlfor
wlcontractingwlhepatitiswlAwlthroughwlthewlfecal-
oralwlroutewlduringwlrecentwltravelwltowlanwlunderdevelopedwlcountrywlandwlthewlclient'swlo
ccupationalwlriskwlaswlawlperioperativewlnursewlforwlcontractingwlhepatitiswlBwlandwlhepatiti
swlCwlthroughwlbloodbornewltransmission.wlThewlnursewlshouldwlrecognizewlthatwlthewlcurr
entwlstandardwlofwlpracticewlfor
Awlnursewliswlcaringwlforwlawlclientwlonwlawlmedical-surgicalwlunit
,VitalwlSigns
0700
Temperaturewl37.6wlCwl(99.7wlF)
Heartwlratewl100/min
Respiratorywlratewl22/min
Bloodwlpressurewl115/70wlmmHg
Oxygenwlsaturationwl98%wlonwlroomwlair
Nurses'wlNotes
1100
Clientwlalertwlandwlorientedwltowlperson,wlplace,wlandwltime.wlClientwlhadwlepisodewlofwldiar
rhea,wlprovidedwlperinealwlcare.wlNotedwl2wlcmwlxwl2wlcmwl(0.8wlinwlxwl0.8wlin)wlpainfulwled
ematouswlareawlonwlsacrum.wlClientwlrepositionedwleverywl4wlhr.wl-wlANS--
Clickwltowlhighlightwlthewlfindingswlthatwlrequirewlfollowwlup.wlTowldeselectwlawlfinding,wlclic
kwlonwlthewlfindingwlagain.
-wlNotedwl2wlcmwlxwl2wlcmwl(0.8wlinwlxwl0.8wlin)wlpainfulwledematouswlareawlonwlsacrum
-wlClientwlrepositionedwleverywl4wlhr
Whenwlrecognizingwlcues,wlthewlnursewlshouldwldeterminewlthatwlthewlclient'swlpainfulwled
ematouswlareawlonwltheirwlsacrumwlandwlthatwlthewlclientwlhaswlonlywlbeenwlrepositionedwl
everywl4wlhrwlrequireswlfollowwlup.wlThewlclientwlhaswlmanifestationswlofwlawlpressurewlinjur
ywlthatwlneedwltowlbewladdressed.wlThewlclientwlshouldwlbewlrepositionedwlatwlleastwleveryw
l2wlhrwltowlpreventwlworseningwlofwlthewlpressurewlinjurywlandwltowlrelievewlpressurewlfromwl
thewlsacralwlarea.
Awlnursewlinwlanwloutpatientwlmentalwlhealthwlclinicwliswlcaringwlforwlawlclient
VitalwlSigns
3wlmonthswlago
Bloodwlpressurewl116/68wlmmHg
Heartwlratewl82/min
Respiratorywlratewl16/min
Temperaturewl36.7wlCwl(98.1wlF)
SaO2wl97%wlonwlroomwlair
Today:
Bloodwlpressurewl128/76wlmmHg
Heartwlratewl104/min
Respiratorywlratewl22/min
Temperaturewl37.4wl(99.4wlF)
SaO2wl97%wlonwlroomwlair
Nurses'wlNotes
3wlmonthswlago
, Clientwlrecentlywladmittedwlwithwlnewwldiagnosiswlofwlschizophrenia.wlReceivedwlinpatient
wltreatmentwlforwl10wldayswlandwlwaswldischargedwl1wlweekwlago.wl-wlANS--
Selectwlthewl3wlfindingswlthatwlrequirewlimmediatewlfollowwlup:
-wlAuditorywlhallucinations
-wlSpeech
-wlRestlessness
Whenwlrecognizingwlcues,wlthewlnursewlshouldwlidentifywlthatwlthewlfindingswlofwlrestlessne
ss,wlauditorywlhallucinations,wlandwlpressuredwlspeechwlrequirewlimmediatewlfollowwlup.wl
Thesewlfindingswlarewlindicationswlofwlpsychosis.wlThewlnursewlshouldwlnotifywlthewlprovid
erwlforwladditionalwlevaluationwlandwltreatment.
Awlnursewliswlcaringwlforwlawlclientwlwhowliswlpostoperativewlfollowingwlcoronarywlarterywlby
passwlsurgerywl(CABG)
LaboratorywlResults
0630
Sodiumwl145wlmEq/Lwl(136wltowl145wlmEq/L)
Potassiumwl3.2wlmEq/Lwl(3.5wltowl5wlmEq/L)
Chloridewl116wlmEq/Lwl(98wltowl106wlmEq/L)
BUNwl24wlmg/dLwl(10wltowl20wlmg/dL)
Magnesiumwl1.5wlmEq/Lwl(1.3wltowl2.1wlmEq/L)
Totalwlcalciumwl9wlmg/dLwl(9wltowl10.5wlmg/dL)
Phosphatewl4.6wlmg/dLwl(3wltowl4.5wlmg/dL)
Glucosewl95wlmg/dLwl(74wltowl106wlmg/dL)
WBCwlcountwl9,500/mm3wl(5,000wltowl10,000/mm3)
Iwl&wlO
0700
4wlhrwlinputwl400wlmL
4wlhrwloutputwl-wlANS--
Thewlclientwliswlatwlgreatestwlriskwlforwldevelopingwldysrhythmias,wlaswlevidencedwlbywlele
ctrolytewlimbalance.
Thewlnursewlshouldwlanalyzewlcueswltowldeterminewlthewlclientwliswlatwlgreatestwlriskwlforwld
evelopingwldysrhythmiaswlrelatedwltowlhypokalemia,wlaswlevidencedwlbywlthewllaboratorywl
reportwlandwlthewlclient'swlreportwlofwlmusclewlcramping.wlPotassiumwlandwlmagnesiumwld
epletionwlarewlcommonwlmanifestationswlinwlclientswlwhowlarewlpostoperativewlfollowingwl
CABG.wlDuewltowlmedicationwlorwlhemodilation,wlitwliswlimportantwlforwlthewlnursewltowlclos
elywlmonitorwlelectrolytes.
Awlnursewliswlcaringwlforwlawlclientwlwhowliswlpregnantwlinwlthewlacutewlcarewlsetting
Nurses'wlNotes
1400
